ObjectiveTo improve and assess the method of establishing myocardial infarction model in New Zealand rabbits. MethodsA total of 60 New Zealand rabbits were randomly divided into two groups:the left anterior descending coronary artery was ligated in a LAD group (n=30); the left circumflex coronary artery was ligated in a LC group (n=30). Electrocardiogram (ECG), ultrasound cardiogram (UCG), hemodynamics and histology procedures were performed to detect the changes of cardiac structure and function after myocardial infarction induced by LAD and LC ligation. ResultsSuccess rate of the LC group was significantly higher than that in the LAD group (P < 0.01), but the survival rate in the LC group was slightly lower than the LAD group (P < 0.05); ECG within 24 h and 1 week after surgery showed that the average values of ST segment elevation in the LC group were significantly higher than that in the LAD group (P < 0.05); UCG and hemodynamics results showed cardiac function in the LAD group did not decrease significantly (P > 0.05). In contrast, cardiac function in the LC group were significantly decreased (P < 0.05). Histopathologic analysis showed that the area of myocardial infarction in the LC group was significantly larger than that in the LAD group (P < 0.01). ConclusionThe myocardial infarction induced by the left circumflex coronary artery ligation is more consistent than that induced by the left anterior descending coronary artery ligation, suggesting that the former is a more appropriate experimental model for evaluations.
Mesenchymal stem cells(MSCs)is a kind of non hematopoietic stem cell from the mesoderm, which can self renew, proliferate and perform multilineage differentiation. Due to the characteristics of acquiring easily and low immunogenicity, it has become the main cell for myocardial infarction. In this article, the biology and the immunology of the MSCs is reviewed, the safety and the validity of the therapy on myocardial infarction with MSCs and the HGF/MSCs is introduced. And furthermore, it also explains the possible mechanism and the problems of how to improve the cardial function.
Objective To report a reliable left heart failure model in sheep using selected ligation of the diagonal branch. Methods Four male sheep were used. After a left anterior thoracotomy in sheep, the diagonal branch of coronary artery was ligated at a point approximately 40% of the distance from the apex to the base of the heart. Hemodynamic and echocardiography measurements were done preligation, 30 minutes and 7 days after the coronary artery of diagonal branch ligation. The electrocardiograms were obtained as needed, and cardiac function was also evaluated. The sheep were killed for postmortem examination of their hearts. Results Four sheep survived the experimental procedures. Comparing with before surgery, systemic arterial blood pressure and cardiac output were decreased, pulmonaryartery systolic pressure, pulmonary capillary wedge pressure and central venous pressure were increased at 30 min and 7 days after selected ligation of the coronary artery of diagonal branch; left ventricular end-diastolic dimension and left ventricular end-systolic dimension were increased; left ventricular ejection fraction and left ventricular fractional shortening were also decreased (Plt;0.05). Conclusion A reliable ovine model of left ventricular failure using selected ligation of the diagonal branch of the coronary artery can be achieved. This animal model is comparable to the clinical correlation.
Objective To investigate the effect of bone marrow mesenchymal stem cell (MSCs) transp1antation combined with transmyocardial drilling revascularization (TMDR) and degradable stent on myocardium revascu1arization after acute myocardial infarction(AMI), and to provide the experimental evidence for surgical treatment of myocardial infarction. Methods After established models of AMI, the 24 pigs were divided into four groups with random number table, 6 pigs each group. Control group: only established models of AMI; MSCs group: AMI immediately followed by MSCs implantation; TMDR combined with stent group: AMI followed by TMDR and absorbable basic fibroblast growth factor (bFGF) stent implantation; MSCs combined with TMDR and stent group: AMI followed by TMDR and absorbable bFGF stent implantation, and then MSCs implantation. Three months after operation, the infarcted areas and vessel density in infarcted zone were detected by histopathology method. Results Three months after operation, the histopathological examination showed that infarcted areas in MSCs group, TMDR combined with stent group, and MSCs combined with TMDR and stent group were decreased as compared with control group （27.9%±3.1% vs. 48.9%±2.7%，P=0.000；20.3%±1.7% vs. 48.9%±2.7%，P=0.000；12.5%±1.9% vs. 48.9%±2.7%，P=0.000）; and vessel density was further increased （8.4±1.2/HP vs.4.5±14/HP，P=CM(1583mm] 0.001；11.5±2.6/HP vs.4.5±1.4/HP，P=0.001;15.6±1.4/HP vs.4.5±1.4/HP，P=0.000）. Conclusion [CM)]MSCs transplantation combined with TMDR and absorbable bFGF stents implantation could significantly reduce the infarction areas, increase the vessel density. This method may enhance the efficacy of MSCs transplantation in acute cardiac infarction model, which provide a new ideas for the surgical treatment of myocardial infarction.
Objective To investigate effects of the autologous bone mesenchymal stem cells (MSCs) enriched by the small intestinal submucosa (SIS) film implantation on the myocardial structure, cardiac function, and compensator y circulation after myocardial infarction in the goats. Methods Sixteen black goats were selected and divided randomly into the control group (n=8)and the experimental group (n=8). The chronic myocardial infarction models were made by the ligation of the far end of the left anterior desc ending coronary artery. At the same time, MSCs were aspired from the thigh bone of the goats in the experimental group. MSCs were isolated by the centrifu gation through a percoll step gradient and purified by the plating culture and depletion of the non-adherent cells. Primary MSCs were cultured in the DMEM me dium supplemented with the fetal bovine serum in vitro. After that, the cultures were labeled by 5- BrdU. The active cells were transplanted into the SIS film. Six weeks after the ligation, the MSCs-SIS film was implanted by its being sutured onto the infarction area; whereas, the control group underwent a shamoperation. In both groups, echocardiographic measurements were performed before infarction, 6 weeks after infarction and 6 weeks after the MSC-collagen mplantion, respectively, to assess the myocardial structure and ca rdiac function. The left coronary artery angiography was performed with the digi tal subtraction angiography. Results In an assessment of the left ventricular function, at 6 weeks after operation, t he stroke volume and the ejection fraction of the control group and the experim ental group were 42.81±4.91, 37.06±4.75 ml and 59.20%±5.41%, 44.56%±4.23%, respectively (Plt;0.05). The enddisatolic volume and the endsystolic volume of the control group and the experimental group were 72.55±8.13, 83.31±8.61 ml and 29.75±5.98, 46.25±6.68 ml, respectively (Plt;0.05). The maximal velocity of peak E of contral group and experimental group were 54.8 5±6.35 cm/s and 43.14±4.81cm/s (Plt;0.01); and the maximal velocity of peak A o f control group and experimental grouop were 52.33±6.65 cm/s and 56.91±6.34 cm/s (Pgt;0.05). Echocowdiogr aphy sho wing a distinctly dilatation of left ventricle with the ventricular dyskinesia i n contral group, but without the ventricular dyskinesia in experimental group. T he selective-coronary evngiography revealed that the obvious compensatory circu l ation established between the anterior descending branch and the left circumflex branch in the experimental group. Conclusion Implantation of the autologus MSCs enriched by the SIS film can prevent dilatation of the left ventricular chamber and can improve the contractile ability of the myocardium, cardiac function, and collateral perfusion.
ObjectiveTo investigate the surgical methods and efficacy of myocardial infarction combined with ventricular septal perforation.MethodsThe clinical data of 60 patients with myocardial infarction combined with ventricular septal perforation admitted to the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, from 2009 to 2018 were retrospectively analyzed. There were 39 males and 21 females, aged 63.3±8.3 years.ResultsAmong the 60 patients, 43 (71.7%) patients were perforated in the apex, 11 (18.3%) in the posterior septum and 6 (10.0%) in the anterior septum. There were 24 (40.0%) patients of single coronary artery disease. Fourteen (23.3%) patients received intra-aortic balloon counterpulsation before surgery. The waiting time from ventricular septal perforation to surgery was 48.3 (3-217) d. All patients underwent ventricular septal perforation repair, among whom 53 (88.3%) patients received ventricular aneurysm closure or resection, and 49 (81.7%) patients received coronary artery bypass graft with an average of 2 distal anastomoses during the same period. Perioperative complications in the hospital included 8 (13.3%) deaths, 8 (13.3%) heart failure, 5 (8.3%) ventricular fibrillation, 3 (5.0%) pericardial tamponade, and 11 (18.3%) secondary thoracotomy and 11 (18.3%) residual shunt. Except for 8 patients who died in the hospital, the other 52 cured and discharged patients were followed up. The median follow-up time was 4.9 years. The 2-year and 5-year survival rate of the patients was 95.8%, and the 8-year survival rate was 89.0%. Major adverse cardiovascular events incidence was 19.2%, including 3 (5.8%) deaths, 5 (9.6%) heart failure, 2 (3.8%) myocardial infarction, and 4 (7.7%) cerebrovascular events.ConclusionFor patients with ventricular septal perforation after myocardial infarction, surgery is an effective treatment method. Although the perioperative mortality rate is high, satisfactory long-term results can be achieved by carefully choosing the operation timing and methods.
ObjectiveTo observe and analyze the short-term efficacy of different statins on acute myocardial infarction in patients with premature coronary heart disease. MethodWe selected 70 patients with acute myocardial infarction admitted into our hospital for treatment of premature coronary artery disease between January 2012 and June 2013. The patients were randomly divided into experimental group (n=35) and control group (n=35). The experimental group were treated with rosuvastatin, and the control group of patients were given atorvastatin. We observed the rate of overall efficiency within 6 months after treatment, and total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), hepersensitive C-reactive protein (hs-CRP), left ventricular ejction fraction (LVEF), and flow-mediated dilation (FMD) were also observed before and after treatment. ResultsThe overall efficacy rate in the experimental group at 6 months was 94.3% and in the control group was 88.6% with no significant difference between each other (P>0.05). TG and FMD of patients in the experimental group at 6 months did not significantly change (P>0.05), while LVEF of the experimental group was significantly higher (P<0.05), and hs-CRP, TC, LDL-C, and HDL-C of the experimental group were significantly lower than the control group (P<0.05). ConclusionsShort-term comprehensive efficacy of rosuvastatin for treatment of premature coronary artery disease in patients with acute myocardial infarction is superior to atorvastatin.
ObjectiveTo identify the risk factors for hospital mortality in patients with acute myocardial infarction (AMI) after emergency coronary artery bypass grafting (CABG).MethodsWe retrospectively analyzed the clinical data of 145 AMI patients undergoing emergency CABG surgery in Qingdao Municipal Hospital from 2009 to 2019. There were 108 (74.5%) males and 37 (25.5%) females with a mean age of 67.7±11.5 years. According to whether there was in-hospital death after surgery, the patients were divided into a survival group (132 patients) and a death group (13 patients). Preoperative and operative data were analyzed by univariate analysis, followed by multivariate logistic regression analysis, to identify the risk factors for hospital mortality.ResultsOver all, 13 patients died in the hospital after operation, with a mortality rate of 9.0%. In univariate analysis, significant risk factors for hospital mortality were age≥70 years, recent myocardial infarction, left ventricular ejection fraction (LVEF)<30%, left main stenosis/dissection, operation time and simultaneous surgeries (P<0.05). Multivariate logistic regression analysis showed that LVEF<30% (OR=2.235, 95%CI 1.024-9.411, P=0.014), recent myocardial infarction (OR=4.027, 95%CI 1.934-14.268, P=0.032), operation time (OR=1.039, 95%CI 1.014-1.064, P=0.002) were independent risk factors for hospital mortality after emergency CABG.ConclusionEmergency CABG in patients with AMI has good benefits, but patients with LVEF<30% and recent myocardial infarction have high in-hospital mortality, so the operation time should be shortened as much as possible.